THE OSTIA VENAE HEPATICAE AND THE RETHROHEPATIC ...

DENGUE INFECTION PRESENTED WITH CENTRAL NERVOUS SYSTEM
MANIFESTATION
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Pongkiat Kankirawatana 1 , Kulkanya Chokephaibulkit 1 , Pilaipan Puthavathana2, Sutee Yoksan 3 ,
Somchai Apintanapong1, Viroj Pongthapisit2 Department of Pediatrics1, Department of Microbiology2,
Faculty of Medicine Siriraj Hospital, And Center for vaccine development, Institute of sciences
and technology for development3, Mahidol University, Bangkok, Thailand.
Key words: Dengue infection, Encephalitis, Encephalopathy
Dengue hemorrhagic fever and Dengue fever are among the most common infectious
diseases in Southeast Asia. Due to the abundant of its vectors, Aedes aegypti in all Southeast Asia
countries, Dengue fever and Dengue hemorrhagic fever impose a substantial cost to the health care in
this region. There have been very few reports on the Dengue manifestation of the central nervous system.
Between 1996-1998, we prospectively studied all pediatric patients with encephalitis who were admitted
to the Department of Pediatrics, Siriraj Hospital. 8 of 44 encephalitic patients were diagnosed as Dengue
infection, 6 by serological diagnosis and 2 by viral isolation. Five of these patients had clinical courses and
laboratory findings compatible with typical Dengue infection. All had obvious encephalitic clinical
manifestations with normal cerebrospinal fluid findings. All of these patients were recovered completely
and had benign clinical course except only one patient developed leakage symptoms. We conclude that
Dengue virus can cause encephalitis and its clinical course and prognosis are usually favorable.
Supported by: Partially supported by China Medical Board Presented at: the Asean Society Neurological
Association Congress, Febuary 1999, Chiangmai, Thailand (Published in : submitted to Journal
of Child Neurology.)
KETOGENIC DIET : AN ALTERNATIVE TREATMENT FOR
REFRACTORY EPILEPSY IN A DEVELOPING COUNTRY
Pongkiat Kankirawatana, Pipop Jirapinyo, Renu Wongarn, Nuchnoi Thamanasiri, Suthida
Kankirawatana.
Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok,
Thailand.
Key words: Ketogenic diet, Refractory Epilepsy, Developing country
Rationale: The aim of this study was to establish the ketogenic diet program in Thailand
and to assess its feasibility as well as its efficacy.
Methods: 30 children with refractory epilepsy were enrolled in the study. All patients
were admitted during the starvation period and the initiation of the ketogenic diet. The classic “4:1”
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